-
positioning and prepping:
-
posterolateral skin incision:
-
incise thru iliotibial band:
-
split gluteus maximus:
- peel back the trochanteric bursa:
- divide trochanteric bursa and sweep it posteriorly to expose vastus lateralis, short
external rotators and posterior border of gluteus
medius;
- this step should be performed carefully so that the surgeon can cleanly dissect the external rotators off their insertion on the greater trochanter;
- once the bursa has been swept posteriorly, the surgeon will have the proper plane to identify the sciatic nerve, and also the interval
between the
piriformis and medius;
-
identify the sciatic nerve
- charnley retractors:
- insert Charnely retractor at the superior border of the greater trochanter;
- retract
maximus posteriorly & tensor fascia anteriorly;
- ensure that the Charnely retractor has not been placed directly over the sciatic nerve;
- elevate minimus off the superior acetabular roof;
- this is facilitated by inserting a homan retractor underneath the
medius and then retracting it anteriorly;
- subsequently a periosteal elevator is used to elevate the
minimus;
-
measure leg lengths:
- dissect the
external rotators and the
posterior capsule off proximal femur:
-
hip dislocation: technique:
Comparison of Primary Total Hip Arthroplasties Performed with a Minimally Invasive Technique or a Standard Technique. A Prospective and Randomized Study.
